Week 5-Medication Flashcards by Mikheil Davis

Medication systems

Automated Dispensers

Self administration

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Automated dispensers

Password accessible lock chart

Computer tracking

Can combine stock and unit doses

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Self administration

Individual containers
Kept at client’s bedside

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Pharmacological considerations

Pharmacokinetics

Pharmacodynamics

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Pharmacokinetics

Movement of drug in the body

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Pharmacodynamics

How does the drug affect the body

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Absorption

Movement of drug into bloodstream

Factors affecting absorption

-route
-solubility of drug
-ph/ionization
-blood flow

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Distribution

Drug transport to tissues and organs
Factors affe ting distribution
-local blood flow
-membrane permeability
-Protein-binding capacity

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Factors affecting Metabolism

Biotransformation-chemical conversion of drug

Factors affecting metabolism
-liver function
-health/disease status
-first-pass effect: liver reduces potency of oral medications

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Route
Drug solubility
Ph and ionization
Blood flow to the area

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Excretion

Elimination of the drug
Factors affecting excretion
-organ function, especially the kidneys, liver, and lungs

-exocrine glands

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Pharmacokinetics concepts

Therapeutic range

Peak level

Through level

Half life

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Therapeutic range

A window of Different levels of therapeutic concentration.

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Peak level

Onset of action is minimum effective concentration.

When drug concentration in blood is at its highest it is at peak level.

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Through level

Drug is at lowest concentration, usually right before dose is due

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Half life

How long it takes for half the drug to be eliminated

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Factors impacting pharmacokinetics

Age

Weight

Gender

Route

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Pharmacodynamics

Primary effects
-Therapeutic effect
-intended
-desired
-why the drug was prescribed

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Primary/therapeutic effects

Are predicted, intended, and desired. Reason drug was prescribed.

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Types of primary/therapeutic effects

Palliative

Restorative

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Palliative

Address signs and symptoms but not disease

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Restorative

Targets disease

Secondary effects

Unintended
Non-therapeutic
Can be
-predictable
-harmless
-harmful

Types of secondary effects

Side effects
Adverse reactions
Toxic reactions
Allergic reactions

Side efffects

Unintended, often predictable, usually well tolerated. Occurs at prescribed dose. Can be immediate or delayed.

Adverse reactions

Harmful unintended, usually unpredictable to drug administered at normal dose More severe than side effects and often require discontinuation of drug

FDA definition of severe adverse reaction

Life threatening Require intervention to prevent death or serious illness Lead to congenital anomaly, Disability, hosp., death Health professionals must document serious adverse reactions according to agency policy and report it to FDA medeatch

Toxic Reactions

Dangerous effects to organ or tissue. Can be cause by: Overdosing(more than prescribed amount) -respiratory depression from excessive morphine -hypoglycemia from too much insulin Accumulation of drug in tissue(continuous use or incomplete metabolism/excretion) Abnormal sensitivity or allergic response: -digoxin can lead to hyperkalemia

Drugs most common in allergic reactions

Antibiotics, biological agents, diagnostic agents

Components of med order

Patient name Date and time Med Dosage Route Frequency Prescriber signature and credentials (DEA number)

Assessing medications

Before During After Med history Physical

Analysis/Nursing Diagnosis

Risk for Injury Ineffective Health Management

How often to check meds before administering

Check 3 times -before you pour •check med label against MAR -after you pour •verify label against MAR -At the bedside • check med again

Six rights

Person Med Dosage Route Time Doc. Other right Reason To know To refuse

Type of routes

PO(most common) Topical Respiratory inhalers Parenteral

Types of PO meds

Tabs, caps Liquid-children and adult. Rapid absorption. Buccal-cheek, rapid absorption Sublingual-under tongue Enteral-patients sho cannot swallow or have feeding tubes. Give meds through NG

Topical

Local and sometimes systemic effects -lotions/creans -transdermal patches -eye and ear -nasal -vaginal -rectal

Respiratory inhaler

Nebulization-mist from liquid drug. Absorbed by airway and alveoli. Absorption via alveoli and blood supply -atomizer:makes large droplets -aerosols:suspends droplets in gas -metered dose inhaler:type of nebulizer that gives measured dosage

Parenteral

Intradermal Subcut Intramuscular Intravenous

Med action takes place in seconds. Ivs very useful in emergency. No way to stop IV adverse reaction, unless there is antidote.

What metabolizes drug

Liver

What happens once drug reaches liver

It is in bloodstream

Do liquid or solid drugs metabolize faster

Liquid

Difference between brand name and generic drugs

Ph ionization

What organ regenrates

Liver

Who usually gets palliative meds

Terminally ill

Do drug side effects require intervention

Yes

Opioid side effects

Constipation Respiratory distress

Do we need for check for contraindication

Yes

Drug metabolism

The reduction of drugs potency/therapeutic effect before being excreted from body

Primary source of drug excretion

Kidneys